• Journal of Korea Association of Health Promotion
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• v.4 no.1
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• pp.12-27
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• 2006

"본 논문은 대한내과학회지 2006년 제70권 제3호에 실렸던 논문으로 대한내과학회 편집위원회의 승인을 득하고 본 협회지에 게재함. Background : Diabetes mellitus is a major independent risk factor for atherosclerosis. In recent years non-invasive high resolution B-mode ultrasound methods have been developed to measure the intima-media thickness(IMT) of the carotid artery as an indicator for early atherosclerosis. Itis known that obesity plays a role in the development of type 2 diabetes and cardiovascular disease, and it has also been reported that not only the amount but also the distribution of body fat is important. This study investigated the relationship between obesity and the development of carotid atherosclerosis in type 2 diabetic patients. Methods: Carotid IMT was measured by ultrasound B-mode imaging in 144 patients with type 2diabetes mellitus. All subjects underwent assessment for the degree and distribution of obesity, the presence of coronary artery disease risk factors, and the presence of diabetic complications. Resuts: Carotid IMT was increased in the abdominal obese group defined by waist circurference. However, there was no significant difference in carotid TMT between the non-obese group and obese group as defined by body mass index, waist to hip ratio, and total body fat percent measured by bio electrical impedance analysis. There were positive correlations between carotid IMT and age, duration of diabetes, systolic blood pressure, and waist circumference. Multiple linear regression analysis revealed the variable that interacted independently with carotid IMT was age in type 2 diabetic patients. Carotid IMT was significantly increased in type 2 diabetic patients with macrovascular complications and microvascvlar complications .Conclusion: This study suggested that abdominal obesity rather than general obesity was associated with carotid atherosclerosis reflected by increment of carotid IMT in type 2 diabetic subjects.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.2
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• pp.125-135
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• 2019

PURPOSE: This study examined the effects of low frequency neuromuscular electrical stimulation (NMES) training on abdominal obesity in middle-aged women through electromyography and ultrasound. METHODS: Twenty-two middle aged women with abdominal obesity participated in the study. A low-frequency NMES device was used on the abdomen and waist of each subject for 20 minutes each (a total of 40 minutes) three times a week for eight weeks. The waist-hip ratio (WHR), weight and BMI (Body Mass Index) were measured. Electromyography (EMG) and ultrasound measurements were performed three times in total (pre-intervention, four weeks into the intervention, and eight weeks post-intervention) to examine the effects of low-frequency NMES on the abdominal muscle activity, muscle thickness, and subcutaneous fat. RESULTS: The results indicated a difference in the WHR and waist circumference before and after intervention (p<.05). The external oblique muscle (EO) showed a significant increase in muscle activity during all measurements taken post-intervention (p<.05). The abdominal subcutaneous fat thickness also showed a significant decrease between each measurement (p<.05). The test results showed that the abdominal subcutaneous fat thickness values taken eight weeks post-intervention were significantly lower than those taken pre-intervention and four weeks into the intervention (p<.05). CONCLUSION: These findings show that low-frequency NMES device training can be applied to middle-aged women with abdominal obesity to improve their body shape and exercise performance.

• Journal of Acupuncture Research
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• v.27 no.6
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• pp.43-57
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• 2010

Objectives : To investigate the effects of electroacupuncture on parameters related to obesity in adults with abdominal obesity. Methods : A three arm randomized single blind pilot study was conducted from Jan 4 to March 25, 2010 in Kyung Hee Oriental Medical Hospital. The subjects were 39 adults with abdominal obesity and were randomly divided by computer generated random table into 3 groups; EA(electroacupuncture), sham EA(sham electroacupuncture) and waitlist groups. Acupuncture points located at abdomen($CV_{12}$, $CV_6$, $ST_{25}$, $SP_{15}$, $SP_{14}$) and extremities($LI_4$, $LI_{11}$, $ST_{36}$, $ST_{44}$) were inserted by disposable stainless steel needles and were stimulated 30 minutes with 24Hz, 0.27~1.3mA(tolerable strength), asymmetric biphasic continuous pulse wave form by STN-111 Stratek device in EA group. Two treatment sessions per week for 5 weeks(10 sessions in total) were done in EA and sham EA groups. The primary outcome measurement was WC(waist circumference), and the secondary outcome measurements included WHR(waist hip ratio), ASF(thickness of abdominal subcutaneous fat), and inbody measurements of BW(body weight), BMI(body mass index), BFR(body fat ratio) and VFA(visceral fat area), and also scores of BULIT-R(bulimia test revised), KoQoL(Korean obesity of QoL) and BSQ(body shape questionnaire). Results : All of 39 subjects were included in ITT(intention-to-treat) analysis. There were significant reductions in WC, WHR and ASF after 5-week electroacupuncture treatments and the percentage reductions were significantly greater than sham EA or waitlist group. There were no significant differences between groups in percentage reductions of other parameters(BW, BMI, BFR, VFA, BULIT-R, KoQoL and BSQ). But, there were continuous reductions in BW, BMI, BFR and VFA at 3 weeks after the end of treatment and there was significant reduction in BW compared with the baseline value in EA group. No seriously adverse effects were reported during the period. Conclusions : Electroacupuncture was more effective than sham electroacupuncture or no intervention on the reduction of WC, WHR and ASF in adults with abdominal obesity.

• The Journal of Internal Korean Medicine
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• v.33 no.3
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• pp.243-256
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• 2012

Objectives : This clinical study was done to examine metabolic syndrome (MS) and plasma homocysteine (HCY) level in patients with silent lacunar infarction (SLI) and in normal controls. Methods : A total of 154 patients, who were over 20 years of age and visited the stroke prevention check-up center of a university hospital from December 2006 to December 2010, were examined by brain CT or brain MRI, and classified into two groups. We compared the components of MS and HCY levels between patients with SLI (n=74) and normal controls (n=80). Modified ATP III definition was used for diagnosis of MS while Korean standard for waist circumference was used. Results : Prevalence of MS was significantly higher in the SLI group than the normal group. HCY was also significantly higher in the SLI group than the noraml, and the odds ratio (OR) for SLI, comparing high HCY level (${\geq}10{\mu}mol/L$) with low HCY level ($<10{\mu}mol/L$), was 3.64 (95% confidence interval (CI); 1.81-7.29, p<.0001). However, there was no correlation between MS and HCY in the SLI group. Prevalence of diabetes and hypertension (HT) was higher in the SLI group than the normal group, but there was no significant difference in blood lipids level between the SLI and normal groups. Of note, HT itself was enough to be an independent risk factor for SLI (OR; 4.58, 95% CI; 1.91-11.01, p=0.001). Body mass index, waist circumference, waist-hip ratio and visceral fat area were significantly higher in the SLI than normal group, and visceral fat area was enough to be an independent risk factor for SLI (OR; 2.41, 95% CI; 1.04-5.59, p=0.040). Conclusions : SLI is shown to have significant correlation with HCY and prevalence of MS, however there is no relationship between HCY and prevalence of MS in patients with SLI.

• Journal of Korean Medicine for Obesity Research
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• v.7 no.1
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• pp.87-96
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• 2007

Objectives : This study was performed to evaluate the effect of oriental medical treatment on aged female obese patient. Methods : We experienced an aged female obese patient. We applied herbal medication(Choweseuncheng-tang), electrolipolysis, auricular acupuncture to her from 26th, March. 2007 to 25th, May. 2007. And we examined the changes of her weight, body composition, body size, skin resistance variability, visual analogue scale of knee pain. Results : 1. Her weight decreased from 73.5kg to 71.1kg and body mass index(BMI) decreased from $29.46kg/m^2$ to $28.11kg/m^2$. 2. Body fat mass(BFM) decreased from 25.7kg to 21.6kg but body muscle mass(BMM) increased from 45.1kg to 46.7kg. 3. Waist-hip ratio(WHR) decreased from 0.96 to 0.92. 4. Basal metabolic rate(BMR) increased from 1,273kcal to 1,314kcal. 5. The circumference of upper extremity decreased 1.03cm and lower extremity decreased 1.30cm but the circumference of the muscle of upper extremity increased 0.41cm and lower extremity increased 0.63cm. 6. The circumference of chest and hip are decreased. In addition to the circumference and fat of abdomen are decreased. 7. The visual analogue scale of knee pain is improved. Conclusions : According to above results, oriental medical treatment could be used safety to aged obese patients without loss of fat free mass. The study is more required to aged obese patient from now on.

• Nutrition Research and Practice
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• v.1 no.4
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• pp.363-370
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• 2007

Single nucleotide polymorphism (SNP) in adiponectin gene has been associated with insulin resistance, diabetes, and cardiovascular disease (CVD). This study was performed to investigate the association of SNP 276G${\rightarrow}$T at adiponectin gene with CVD risk factors in Korean type 2 diabetes mellitus (DM) patients. The subjects were 351 type 2 DM patients visited a DM clinic in Seoul, and the patients with known CVD were excluded. The adiponectin SNP 276G${\rightarrow}$T was analyzed and dietary intakes were assessed by a Food Frequency Questionnaire. The prevalence of G/G, G/T, and T/T genotype was 47.6%, 43.3%, and 9.1%, respectively. Male subjects with T/T genotype showed significantly lower level of adiponectin and HDL-cholesterol and significantly higher C-reactive protein (CRP) level compared to G/G and G/T genotypes. In G/G genotype, protein intake was negatively correlated to body weight, BMI, and waist circumference, and there were positive correlation between carbohydrate intake and BMI, waist-hip ratio, and ApoB/apoA-1 ratio in G/T genotype. However, in T/T genotype, there was no significant association between macronutrient intakes and anthropometric and hematological values. In conclusion, CVD risk would be high in type 2 DM patients with T/T genotype, and the association of macronutrient intakes with anthropometric and hematologic factors was different among the three adiponectin genotypes. These results may imply the need for different dietary management regime according to adiponectin genotype to lower CVD complications in Korean type 2 DM patients.

• Korean Journal of Community Nutrition
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• v.13 no.2
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• pp.288-297
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• 2008

It has been reported frequently that clinical features of gallstone disease in Korean were similarly changing to those of Occidentals. This changing was thought to be due to Westernized lifestyle and dietary patterns in Korean. The purpose of this study was to investigate the nutritional risk factor among patients with gallstone. The subjects of this study were 90 gallstone group with biliary stone as confirmed by cholecystectomy and 111 control group with no biliary stone as confirmed by ultrasonography adjusted according to age and gender. Anthropometric indices and biomarkers were measured and dietary habit as well as nutrient consumption pattern were investigated using a structured checklist of health-related eating behavior and a semi-quantitative food frequency questionnaire. The mean age was higher in GG (gallbladder stone patient group) than CG (control group). The average BMI and WHR (waisthip ratio) tended to be higher than those in CG. WC (waist circumference) and WHR of women in GG were significantly higher than in CG. GG had lower levels in TC (p < 0.01), LDL-C (p < 0.05), and HDL-C (p < 0.05), but higher FBG levels (p < 0.001). GG tended to be associated with lower physical activity and more frequent consumption of meat, meats with high fat and high sugar content food. The consumption levels of fiber (p < 0.05), vitamin C (p < 0.05), calcium (p < 0.01) in GG were significantly lower than in CG. These findings showed that the association with incidence of gallbladder stone and anthrophometric indices and dietary consumption patterns. Further study may be necessary to elucidate the dietary risk factors in the changing patterns of gallstone disease.

• Journal of the East Asian Society of Dietary Life
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• v.26 no.1
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• pp.25-33
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• 2016

The study was performed to investigate the effects of whey protein-rich meal substitute added with vitamins, minerals, and lactobacillus powder probiotics on weight loss, body fat, and body composition in 24 female volunteers for 4 weeks. Whey protein-rich meal substitute was consumed with low-fat, high calcium milk (1% fat, 260 mg/200 mL) twice a day. Subjects submitted 3-day diet records and a life-style questionnaire before the study. During the study, subjects were required to turn in a diet record every day and consume the meal substitute formula in the metabolic ward at C university for 4 weeks. Anthropometric measurements were carried out weekly by Inbody 7.0. The dietary intake and anthropometric data were analyzed to compare changes before and after the study by paired t-test with SPSS version 23.0. The subjects were mostly early 20's and either overweight or obese and highly motivated to lose weight. Most of the subjects consumed three meals per day regularly and spent mostly 10~15 minutes for a meal. Their caloric intake was relatively low and decreased from 1,360 kcal at week 0 to 1,100 kcal after 4 weeks. However, total protein intake increased while carbohydrate and fat intakes decreased (p<0.05) after the trial. Nine vitamin intakes after the study improved compared to those before the study (p<0.05). After the study, subjects showed lower body weight (-1.8 kg), body fat (-0.94 kg), percent body fat (-0.86%), as well as waist circumference (-4.52 cm), hip circumference (-0.44 cm), waist hip ratio (-0.05), and triceps skinfold thickness (-2.39 mm) compared to those at week 0 (p<0.05). Muscle mass tended to be less compared to week 0, although there was no significant differences between weeks 0 and 4. In conclusion, diet trial with whey protein-rich meal substitute induced weight loss and positively changed body fat parameters and body composition.

• Journal of Chest Surgery
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• v.28 no.3
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• pp.233-236
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• 1995

Subepicardial space is one of the regions in which fat in moderate amount is normally deposited. When excess deposits of epicardial fat occur, penetration or infiltration of fat into the connective tissues between muscle bundles is observed. In some cases with very extensive involvement of epicardial fat,myocardial insufficiency and conduction system defect such as heart block have been implicated. More fat is deposited over the right ventricle than over left and the anterior surface contains more fat than dose the posterior surface. We studied 40 patients who underwent open heart surgery under the cardiopulmonary bypass. This study was designed to evaluate the percentage of the area of epicardial fat of the right ventricular anterior surface, which is more accessible area during the operative procedure. Other variables included thickness of subcutanous tissue of anterior chest wall, the ratio of waist to hip circumference, body weight and age. In conclusion, the amount of the epicardial fat correlates with thickness of the subcutaneous fat of the anterior chest wall and simple linear regression analysis indicates good correlation with body weight. Increased age results in large amount of epicardial fat.

• Journal of Nutrition and Health
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• v.32 no.6
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• pp.732-738
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• 1999

This study was performed to investigate the risk factors for coronary heart disease in elderly women. Seventy five elderly women over 65 years of age participated with 35 elderly men over 65 years of age, 40 middle-aged men and 31 middle-aged women as control subjects. The percentage of body fat(34.1 5.6%) in elderly women found to be significantly higher than in other groups and their waist/hip circumference ratio(WHR) was higher than in middle-aged women. The concentrations of plasma total cholesterol and LDL-cholesterol in elderly women were higher than in other groups, TG concentration higher than in middle aged women and HDL-cholesterol % lower than in other groups. Plasma cholesterol ester transfer protein(CETP) activities of elderly women were significantly higher than in middle-aged subjects, but were not different from those of elderly men. Plasma Apolipoprotein(Apo) A-I level in elderly women was higher than in middle-aged men but not different from the other groups. Differences among groups were not great in Lipoprotein (Lp)(a)levels. CETP activities were significantly correlated with age, body fat % total cholesterol, LDL-cholesterol and Lp(a). Therefore, it appears that the increased risk of coronary heart disease in elderly women is due to the increase of body fat, central adipose distribution, serum total cholesterol, LDL-cholesterol and CETP activities.